U.S. Department of Health and Human Services
Using MSIS Data to Analyze Medicaid Eligibility and
Managed Care Enrollment Patterns in 1999
Appendix C. MSIS Managed Care Table Footnotes
Listed below are state-by-state footnotes that describe any known
problems with the 1999 MSIS data. At the end of each footnote is a list of the
state-level tables for which the footnote is relevant. The Annual (A) tables
for 1999 are listed first, followed by the Monthly (M) tables that relate to
December 1999. However, the numbering for the state tables differs from the
numbering for the national tables. National tables 1-5 correspond to Annual (A)
tables 1-5 for the states. National tables 6-14 correspond to Monthly (M)
tables 1-9 for the states. An exhibit following the footnotes summarizes how
the numbering corresponds for the national-level tables and the state-level
tables.
Links to each state's tables are provided after the specific state name,
as well as at the end of this page.
- In October 1999, Alabama terminated its 1115 program. A: 1
- In October 1999, an HMO (Bay Health Plan in Mobile County) was
discontinued. A: 3A-B, 4A-B, 5
- The "other" managed care plan type in Alabama is a prepaid plan
network that covers only inpatient care. A: 3A-B, 4A-B; M: 1A-B, 2A-B, 3A-B,
4A-B, 5A-F, 6A-F, 7A-D, 8A-D 9
- Although disparities exist between MSIS Medicaid managed care counts
(for HMOs and PCCMs) and other sources, Alabama officials assert that the MSIS
counts are more accurate. A:3A-B, 4A-B, 5
- In Alaska, enrollment generally increased from month 1 to month 3 of
each quarter and then decreased somewhat in month 1 of the next quarter. This
recurring pattern of monthly enrollment within a quarter seems unlikely. The
state's data should not be used for analysis of month-to-month enrollment,
although it appears to be reliable at a more general level. A:1, 2A-B, 3A-B,
4A-B
- Arizona underreported foster care children in the January - March
period. A: 1, 2A-B
- Arizona used the "other" managed care plan type for new enrollees who
had not yet selected a managed care plan. A: 3A-B, 4A-B; M: 1A-B, 2A-B, 3A-B,
4A-B, 5A-F, 6A-F, 7A-D, 8A-D 9
- The Arkansas data on disabled dual eligibles are not reliable. M: 7B,
7D, 8B, 8D
- The adults in the Arkansas 1115 demonstration only qualified for
family planning benefits. A:1
- Managed care enrollment was undercounted for Arkansas in MSIS 1999.
Arkansas only reported PCCM enrollment for ARKids, a subset of PCCM enrollees.
In addition, the state was not reporting any PHP enrollment. CMS managed care
data indicated that 232,122 persons were enrolled in PHP plans in June, 1999.
A: 3A-B, 4A-B; M: 1A-B, 2A-B, 3A-B, 4A-B, 5A-F, 6A-F, 7A-D, 8A-D, 9
- California introduced a very large 1115 waiver program (FPACT) in
December, 1999, that only covered family planning benefits for working age
women. A: 1, 2A-B
- CMS and MSIS data in 1999 differed with regard to how a small group
of enrollees (<30,000/month) in hybrid PCCM plans and pilot managed care
programs were reported. In CMS data, all of these enrollees were reported as
enrolled in PCCMs. In MSIS, most (but not all) of the enrollees in hybrid PCCM
plans and pilot managed care plans were reported into the "other" managed care
plan type. However, a small subset of these enrollees were mistakenly reported
into the PCCM plan type in MSIS. Another way in which California MSIS data
differ from the CMS managed care data is that considerably more enrollees are
reported for dental managed care enrollment in MSIS than the CMS report. A:
3A-B, 4A-B, 5; M: 1A-B, 2A-B, 3A-B, 4A-B, 5A-F, 6A-F, 7A-D, 8A-D, 9
- The "Other Combinations" grouping included enrollees who were dually
enrolled in dental managed care and the pilot programs listed under PCCM plans.
A: 4A-B; M: 2A-B, 4A-B, 6A-F, 8A-D
- The reporting into the poverty-related disabled group (eligibility
group 32) is not reliable for 1999 since about half of the persons reported
into this group were enrolled in managed care plans. These individuals should
have been reported into the other disabled group (eligibility group 42). The
poverty-related disabled group in Colorado should only include those qualifying
for restricted Medicaid benefits related to Medicare cost-sharing. A: 1; M:
3A-B, 4A-B, 5A-F, 6A-F, 7B, 7D, 8B, 8D
Connecticut [PDF] [Excel]
No footnotes.
- During 1999, Delaware changed how it was reporting children and
adults into eligibility groups. As a result, any analysis of monthly enrollment
patterns by eligibility group for children and adults would be difficult. A: 1
- Most of the adults in Delaware's 1115 demonstration qualified for
full Medicaid benefits; however, a relatively small group of women
(<100/month) only qualified for extended family planning benefits. A: 1
District of Columbia [PDF] [Excel]
- The District of Columbia extends full Medicaid benefits to the aged
and disabled with income <100 percent of the federal poverty level (FPL). As
a result, the disabled poverty-related group included both dual eligibles and
persons who were not dual eligibles. M: 7B, 7D, 8B, 8D
- Florida extends full Medicaid benefits to the aged and disabled with
income <100 percent of the federal poverty level (FPL). As a result, the
disabled poverty-related group included both dual eligibles and persons who
were not dual eligibles. M: 7B, 7D, 8B, 8D
- Florida generally coded enrollees in its MediPass plan as PCCMs.
However, enrollees with mental health MediPass providers were coded to BHPs.
Although MSIS reports approximately 11,000 fewer enrollees in BHPs than CMS
reported in its PHP count, Florida officials assert that the MSIS numbers are
accurate. A:3A-B, 4A-B, 5
- In Georgia, enrollment generally decreased from month 1 to month 3 of
each quarter and then increased somewhat in month 1 of the next quarter. This
recurring pattern of monthly enrollment within a quarter seems unlikely. The
state's data should not be used for analysis of month-to-month enrollment,
although it appears to be reliable at a more general level. A:1, 2A-B, 3A-B,
4A-B
- CMS and MSIS managed care data for 1999 are not consistent. The MSIS
data show about 20,000 persons in June, 1999 enrolled in a comprehensive HMO
(the Grady HealthCare, Inc.), while CMS data counted the Grady enrollees under
the PHP grouping. In addition, the CMS managed care report included about 2000
individuals in a Mental Health BHP that was not reported in MSIS because it is
a 1915c waiver program. Finally, MSIS data showed fewer PCCM enrollees than
CMS, but information was not available on which counts are more reliable.
A:3A-B, 4A-B, 5
- Beginning in Q1 FY2000, GA reported an unlikely increase in
enrollment in county code 009. The state has acknowledged that the code was
incorrectly assigned for numerous records and is investigating why this
occurred. M: 9
- Hawaii used more restrictive rules to determine Medicaid eligibility
for SSI recipients, under the 209(b) provisions. A: 1
- Hawaii extends full Medicaid benefits to the aged and disabled with
income <100 percent of the federal poverty level (FPL). As a result, the
disabled poverty-related group included both dual eligibles and persons who
were not dual eligibles. M: 7B, 7D, 8B, 8D
- MSIS managed care data showed lower enrollment in Medicaid HMOs than
the CMS managed care report; however, Hawaii officials assert that the MSIS
numbers are accurate. A:3A-B, 4A-B, 5
- In October 1999, Idaho began to report some individuals into the SSI
disabled group who were previously reported into the other disabled eligibility
group. A: 1
- Dual eligibility among both the aged and the disabled was
underreported in 1999. M: 7A-D, 8A-D
- The "other" managed care plan type in Illinois included prepaid plans
providing a different service package than comprehensive managed care plans.
One of these plans was terminated in October, 1999, causing a drop in overall
enrollment. A: 3A-B, 4A-B; M: 1A-B, 2A-B, 3A-B, 4A-B, 5A-F, 6A-F, 7A-D, 8A-D, 9
- Illinois used more restrictive rules to determine Medicaid
eligibility for SSI recipients, under the 209(b) provisions. In addition, the
state was not able to report all SSI recipients who enrolled in Medicaid into
the aged SSI and disabled SSI eligibility groups in MSIS; SSI recipients are
reported in other eligibility groups as well. A: 1
- Indiana used more restrictive rules to determine Medicaid eligibility
for SSI recipients, under the 209(b) provisions. A: 1
- The "Other Combinations" grouping included enrollees who were dually
enrolled in HMOs and PCCMs. A: 4A-B; M: 2A-B, 4A-B, 6A-F, 8A-D
No footnotes
- In 1999, foster care children were underreported in the Kansas MSIS
data, with only about half the foster care group identified. The remaining
foster care children were reported into the other child eligibility group. A:1,
2A-B; M: 3A-B, 4A-B, 5A-F, 6A-F
- From January through April 1999 (when a separate state SCHIP program
was being implemented), Kansas had problems separating children who should have
been reported into the AFDC child and poverty-related child groups. As a
result, the monthly enrollment patterns for these child eligibility groups are
not reliable during this period. A: 1
- Kansas may have overreported managed care enrollment in 1999 MSIS.
Both the HMO and PCCM enrollment numbers are about 26 percent greater than the
comparable counts in the CMS managed care reports. Kansas officials are unable
to explain why the difference occurred. A: 3A-B, 4A-B; M: 1A-B, 2A-B, 3A-B,
4A-B, 5A-F, 6A-F, 7A-D, 8A-D, 9
- In Kansas MSIS data, dually eligible aged enrollees were
under-identified due to an MSIS coding problem. M: 7A, 7C
- CMS and MSIS show somewhat different counts for HMO and PCCM
enrollment in June, 1999, but information is not available on which numbers are
more reliable. The "other" managed care plan type in Kentucky was a special
capitation plan for transportation benefits; this transportation plan type was
not reported in CMS data. A: 3A-B, 4A-B; M: 1A-B, 2A-B, 3A-B, 4A-B, 5A-F, 6A-F,
7A-D, 8A-D 9
- The Kentucky data on disabled dual eligibles are not reliable. M: 7B,
7D, 8B, 8D
- In 1999, Louisiana MSIS data only identified about 87 percent of the
aged as dual eligibles, a somewhat lower than expected proportion. M: 7A, 7C,
8A, 8C
- Managed care in Louisiana was undercounted in 1999 MSIS. Louisiana
did not identify any PCCM enrollees in MSIS data in 1999; however, the state
has indicated that about 44,000 Medicaid enrollees participated in a hybrid
PCCM plan each month, as reported in the CMS managed care data. A: 3A-B, 4A-B;
M: 1A-B, 2A-B, 3A-B, 4A-B, 5A-F, 6A-F, 7A-D, 8A-D, 9
- Maine extends full Medicaid benefits to the aged and disabled with
income <100 percent of the federal poverty level (FPL). As a result, the
disabled poverty-related group included both dual eligibles and persons who
were not dual eligibles. M: 7B, 7D, 8B, 8D
- CMS and MSIS show somewhat different counts for HMO and PCCM
enrollment in June, 1999, but information is not available on which numbers are
more reliable. A: 3A-B, 4A-B; M: 1A-B, 2A-B, 3A-B, 4A-B, 5A-F, 6A-F, 7A-D, 8A-D
9
- In November and December, 1999, Maryland enrolled approximately
60,000 individuals whose Medicaid benefits had been improperly terminated in
1997 (during the implementation of welfare reform). For administrative
convenience, the state decided to report these individuals into the medically
needy disabled eligibility group. These individuals should have been reported
into the AFDC or other eligibility groups (14, 15, 44 or 45). This error was
eventually corrected in MSIS data, but not in time for these tables. A: 1,
2A-B; M: 3A-B, 4A-B, 5A-F, 6A-F, 7B, 7D, 8B, 8D
- In 1999, Maryland MSIS data only identified about 89 percent of the
aged and 20 percent of the disabled as dual eligibles, both somewhat lower than
expected proportions. The state reported that it was experiencing delays in
establishing dual eligibility status. M: 7A-D, 8A-D
Massachusetts [PDF] [Excel]
- Throughout 1999, Massachusetts underreported foster care children in
MSIS data. A:1, 2A-B; M: 3A-B, 4A-B, 5A-F, 6A-F
- Massachusetts extends full Medicaid benefits to the aged and disabled
with income <100 percent of the federal poverty level (FPL). As a result,
the disabled poverty-related group included both dual eligibles and persons who
were not dual eligibles. M: 7B, 7D, 8B, 8D
- The "Other Combinations" grouping includes enrollees who were dually
enrolled in HMOs and PCCMs (and possibly BHPs), or were enrolled in both PACE
and BHPs. A: 4A-B; M: 2A-B, 4A-B, 6A-F, 8A-D
- Michigan's 1999 MSIS enrollment data did not include BHP enrollment.
This error will eventually be corrected in MSIS data, but not in time for these
tables. A: 3A-B, 4A-B; M: 1A-B, 2A-B, 3A-B, 4A-B, 5A-F, 6A-F, 7A-D, 8A-D, 9
- PCCM enrollment in Michigan phased out in April, 1999. A: 3A-B, 4A-B
- Michigan extends full Medicaid benefits to the aged and disabled with
income <100 percent of the federal poverty level (FPL). As a result, the
disabled poverty-related group included both dual eligibles and persons who
were not dual eligibles. M: 7B, 7D, 8B, 8D
- Throughout 1999, the eligibility group assignment in Minnesota is not
reliable, except to the extent individuals are identified as aged, disabled,
children (including foster care children) or adults. The state only recently
discovered a long-standing coding error in its MSIS data related to income, and
income is a critical variable to the assignment of individuals across the
eligibility groups. A: 1, 2A-B; M: 3A-B, 4A-B, 5A-F, 6A-F, 7A-D, 8A-D
Mississippi [PDF] [Excel]
- HMO enrollment in Mississippi was terminated in November, 1999. A:
3A-B, 4A-B, 5
- Mississippi extends full Medicaid benefits to the aged and disabled
with income <100 percent of the federal poverty level (FPL). As a result,
the disabled poverty-related group included both dual eligibles and persons who
were not dual eligibles. M: 7B, 7D, 8B, 8D
- In February 1999, Missouri began full implementation of an 1115
program for adults. A: 1
- Missouri undercounted managed care enrollment until October 1999 in
MSIS. The CMS data for June, 1999 on HMO enrollment are more reliable than the
MSIS data. A: 3A-B, 4A-B, 5
- CMS administrative data indicate that Montana had PHP enrollment of
about 70,000 in June 1999. Montana officials assert that these CMS numbers are
incorrect and are an artifact of old, incorrect managed care data. A:3A-B,
4A-B, 5
- Because Nebraska was converting to a new eligibility system in 1999,
the state was unable to report about 5,000-6,000 eligibles each month into the
appropriate MSIS eligibility group. A:1, 2A-B; M: 3A-B, 4A-B, 5A-F, 6A-F
- Nebraska extends full Medicaid benefits to the aged and disabled with
income <100 percent of the federal poverty level (FPL). As a result, the
disabled poverty-related group included both dual eligibles and persons who
were not dual eligibles M: 7B, 7D, 8B, 8D
No footnotes.
New Hampshire [PDF] [Excel]
- Managed care HMO enrollment may be underreported in MSIS 1999, since
the MSIS HMO enrollment numbers are less than half the level reported to CMS in
Medicaid managed care reports for June, 1999. Enrollment in the Tufts Health
Plan was reported in CMS data, but not MSIS. A: 3A-B, 4A-B; M: 1A-B, 2A-B.
3A-B, 4A-B, 5A-F, 6A-F, 7A-D, 8A-D, 9
- New Hampshire used more restrictive rules to determine Medicaid
eligibility for SSI recipients, under the 209(b) provisions. This may explain
why relatively few SSI children were reported in the MSIS data. M: 5A-F, 6A-F
- New Jersey extends full Medicaid benefits to the aged and disabled
with income <100 percent of the federal poverty level (FPL). As a result,
the disabled poverty-related group included both dual eligibles and persons who
were not dual eligibles M: 7B, 7D, 8B, 8D
- The "other" managed care plan type in New Jersey is a capitated
pharmaceutical program for persons in long term care. However, the monthly
counts for "other" managed care are not reliable except for February, March,
May and June, 1999. A: 3A-B, 4A-B; M: 1A-B, 2A-B, 3A-B, 4A-B, 5A-F, 6A-F, 7A-D,
8A-D 9
- New Mexico implemented an 1115 waiver in March, 1999 for its M-CHIP
program. A: 1, 2A-B
- New York was not able to identify QMB-only and SLMB-only
poverty-related enrollees who would be reported into eligibility groups 31-32.
In addition, the state did not report any adults into eligibility group 45
(other adults). A: 1, 2A-B, 3A-B, 4A-B, 5; M: 1A-B, 2A-B, 3A-B, 4A-B, 5A-F,
6A-F, 7A-D, 8A-D
- New York's managed care data in MSIS may not be reliable for the
first part of 1999. From March to April, HMO enrollment decreased by over
one-third, and PCCM enrollment decreased by over half. In addition, the MSIS
enrollment numbers for BHPs and PCCMs were not consistent with other CMS data
on managed care enrollment for June, 1999. A: 3A-B, 4A-B, 5; M: 1A-B, 2A-B,
3A-B, 4A-B, 5A-F, 6A-F, 7A-D, 8A-D, 9
- In 1999, Medicaid enrollees in the boroughs of New York City were not
assigned FIPS county codes. Instead, they were all reported together in a row
labeled NYC at the end of Table 9. M: 9
North Carolina [PDF] [Excel]
- North Carolina reported <1,000 individuals into the unknown
eligibility group each month until November. These individuals were refugees
who did not qualify as regular Title XIX enrollees. A: 1
- North Carolina terminated its AFDC-U (unemployed parent) coverage
effective November, 1999. A: 1
- North Carolina reported its 1915b Carolina Alternatives contract as a
comprehensive managed care plan in MSIS, while this plan was reported as a PHP
in CMS managed care data. Enrollment in this plan expired effective July, 1999.
A: 3A-B, 4A-B, 5
- North Carolina extends full Medicaid benefits to the aged and
disabled with income <100 percent of the federal poverty level (FPL). As a
result, the disabled poverty-related group included both dual eligibles and
persons who were not dual eligibles M: 7B, 7D, 8B, 8D
- The "Other Combinations" grouping included enrollees who were dually
enrolled in HMOs and PCCMs. A: 4A-B; M: 2A-B, 4A-B, 6A-F, 8A-D
North Dakota [PDF] [Excel]
No footnotes
No footnotes
- Foster care children are underreported in Oklahoma MSIS data during
1999, because the state was unable to identify foster care children on Medicaid
qualifying under the Title IV-E provisions. A:1, 2A-B; M: 3A-B, 4A-B, 5A-F,
6A-F
- Oklahoma's enrollment in uniform groups 14-15 and 44-45 fluctuated
during the last 6 months of 1999. This may have been caused by difficulties
with TANF delinking. A:1
- The "other" managed care plan type in Oklahoma is a hybrid PCCM in
which the capitation fee to physicians also covers a limited number of common
office procedures and lab work. Enrollment in this plan is reported as a PCCM
in the CMS managed care reports. A: 3A-B, 4A-B; M: 1A-B, 2A-B, 3A-B, 4A-B,
5A-F, 6A-F, 7A-D, 8A-D 9
- Some disparity exists between the June 1999 CMS and MSIS managed care
enrollment numbers for HMOs and PCCMs. It appears as if there was an error in
the data reported to CMS. The MSIS numbers are consistent with data from the
state's website in FY99. A:3A-B, 4A-B, 5
- The "Other Combinations" grouping includes enrollees who were either
only enrolled in PACE, or enrolled in both PACE and a BHP or dental managed
care. A: 4A-B; M: 2A-B, 4A-B, 6A-F, 8A-D
Pennsylvania [PDF] [Excel]
- Pennsylvania extends full Medicaid benefits to the aged and disabled
with income <100 percent of the federal poverty level (FPL). As a result,
the disabled poverty-related group included both dual eligibles and persons who
were not dual eligibles M: 7B, 7D, 8B, 8D
- Information on dual eligible status was not available in 1999 for
Pennsylvania. M: 7A-D, 8A-D
- In July and August, 1999, enrollment in eligibility groups 14 and 15
increased when Pennsylvania reinstated some persons improperly terminated from
Medicaid as a result of welfare reform. In addition, the state began reporting
into eligibility groups 16 and 17. A: 1, 2A-B, 3A-B, 4A-B, 5A-F, 6A-F
- Managed care enrollment may be underreported in MSIS 1999, since
Pennsylvania failed to report any PCCM enrollment. According to CMS managed
care reports, about 154,000 persons were enrolled in Medicaid PCCM plans in
June, 1999. A: 3A-B, 4A-B; M: 1A-B, 2A-B. 3A-B, 4A-B, 5A-F, 6A-F, 7A-D, 8A-D, 9
Rhode Island [PDF] [Excel]
- The adults in the Rhode Island 1115 demonstration only qualified for
family planning benefits. A:1, 2A-B 2. Medicaid enrollees living out of state
were reported under county FIPS code 000. M: 9
South Carolina [PDF] [Excel]
- Beginning in October, 1999, South Carolina reported SSI disabled
persons age 65 and over as "disabled." Prior to this, they were reported as SSI
aged. A: 1
- South Carolina extends full Medicaid benefits to the aged and
disabled with income <100 percent of the federal poverty level (FPL). As a
result, the disabled poverty-related group included both dual eligibles and
persons who were not dual eligibles M: 7B, 7D, 8B, 8D
- South Carolina's Physicians Enhanced Program (PEP) is a hybrid
managed care program reported into the "other" managed care plan type. A: 3A-B,
4A-B; M: 1A-B, 2A-B, 3A-B, 4A-B, 5A-F, 6A-F, 7A-D, 8A-D 9
- MSIS reported 6,000 fewer enrollees in South Carolina's "Other"
managed care plans than CMS records. This difference occured because the State
did not regard its "high-risk channeling project" enrollees to be in managed
care, while CMS did because the project requires capitated payments. A:3A-B,
4A-B
South Dakota [PDF] [Excel]
- Managed care enrollment is underreported, since a large proportion of
Medicaid enrollees in South Dakota were enrolled in a dental managed care plan
throughout 1999 according to state officials. However, this enrollment was not
reported in MSIS until 2000. A: 3A-B, 4A-B; M: 1A-B, 2A-B. 3A-B, 4A-B, 5A-F,
6A-F, 7A-D, 8A-D, 9
- Until October, 1999, about 4,000 persons under age 65 were
incorrectly reported into the aged poverty-related eligibility group (group 31)
each month. This change accounts for part, but not all, of the decline in this
group in October. A: 1
- CMS and MSIS managed care data are consistent with regard to PCCM
enrollment in June, 1999, but MSIS shows more enrollees in HMOs than CMS.
Information is not available on which source is more reliable with regard to
HMO enrollment. A: 3A-B, 4A-B
- In July, 1999, Texas began enrolling persons on Medicaid in a BHP
plan. A: 3A-B, 4A-B
- Texas reported persons eligible for extended Medicaid benefits as a
result of a TANF 1115 waiver into eligibility group 55. A:1, 2A-B; M:3A-B, 4A-B
- Approximately 30,000 children each month were assigned to the other
child eligibility group (group 44) during 1999 who should have been assigned to
the poverty-related child group (group 34). A: 1; M: 3A-B, 4A-B
- Utah extends full Medicaid benefits to the aged and disabled with
income <100 percent of the federal poverty level (FPL). As a result, the
disabled poverty-related group included both dual eligibles and persons who
were not dual eligibles M: 7B, 7D, 8B, 8D
- CMS and MSIS managed care data are consistent with regard to PCCM
enrollment in June, 1999, but CMS shows more enrollees in HMOs than MSIS.
Information is not available on which source is more reliable with regard to
HMO enrollment. A: 3A-B, 4A-B
- Vermont has an 1115 waiver that extends eligibility (with full
benefits) to various groups of children and adults. In addition, aged and
disabled dual eligibles, who ordinarily would only qualify for Medicare
cost-sharing, also receive limited pharmacy benefits under the waiver. A: 1,
2A-B; M: A-B, 4A-B, 5A-F, 6A-F, 7A-D, 8A-D
- Vermont implemented a PCCM program in October, 1999. A: 3A-B, 4A-B, 5
- CMS and MSIS managed care data are not consistent with regard to HMO
enrollment in June, 1999, but the MSIS data are believed to be more reliable.
A: 3A-B, 4A-B, 5
- In April, 1999, the mix of HMOs changed somewhat, and overall
enrollment in HMOs increased. PCCM enrollment declined by about the same
number. A: 3A-B, 4A-B, 5
- Most persons in county codes 975-997 were in institutions. M: 9
- In Washington, enrollment generally declined from month 1 to month 3
of each quarter and then increased somewhat in month 1 of the next quarter.
This recurring pattern of monthly enrollment within a quarter seems unlikely.
The state's data should not be used for analysis of month-to-month enrollment,
although it appears to be reliable at a more general level. A: 1, 2A-B
- Managed care in Washington was undercounted in the 1999 MSIS data.
Washington failed to report its behavioral health plan enrollment into MSIS in
1999, estimated to cover most Medicaid enrollees each month. A: 3A-B, 4A-B; M:
1A-B, 2A-B, 3A-B, 4A-B, 5A-F, 6A-F, 7A-D, 8A-D, 9
- HMO managed care enrollment generally increased from month 1 to month
3 of each quarter and then decreased somewhat in month 1 of the next quarter.
This recurring pattern of monthly HMO enrollment within a quarter seems
unlikely. The state's data should not be used for analysis month-to-month HMO
enrollment, although it appears to be reliable at a more general level. A:
3A-B, 4A-B
West Virginia [PDF] [Excel]
- In November 1999, HMO enrollment decreased, when one HMO plan was
terminated. A: 3A-B, 4A-B, 5
- In 1999, West Virginia only identified about 20 percent of the
disabled as dual eligibles, a somewhat lower than expected proportion. M: 7B,
7D, 8B, 8D
- The 728 people in September, 1999 with an "unknown" managed care
plan status resulted from a coding error. A: 3A-B, 4A-B
- The "Other Combinations" grouping includes enrollees who were dually
enrolled in HMOs and PCCMs. A: 4A-B; M: 2A-B, 4A-B, 6A-F, 8A-D
- Wisconsin began implementation of its 1115 Badger Care demonstration
for children and adults during 1999. A: 1
- The "other" managed care plan type in Wisconsin was for a capitated
program covering short-term, physician-ordered nursing home stays for persons
with physical, developmental or emotional disabilities. A: 3A-B, 4A-B; M: 1A-B,
2A-B, 3A-B, 4A-B, 5A-F, 6A-F, 7A-D, 8A-D 9
- Wisconsin used special county codes reported here as 999 (unknown) to
identify Medicaid enrollees in juvenile correction agencies, Relief to Needy
Indian Person agencies, Division of Family and Children Service agencies or
disabled children qualifying under the so-called "Katie Beckett" provisions. M:
9
- Some inconsistencies in the MSIS and CMS managed care counts for
PCCM, BHP and other managed care enrollment for June, 1999 may have occurred
because of differences in how the groups were reported. A: 3A-B, 4A-B, 5
No footnotes.
| TABLE NUMBERS FOR THE NATIONAL- AND STATE-LEVEL
TABLES |
| Table
Title |
National-Level
Table
Number |
State-Level
Table
Number |
| Medicaid Enrollment by Eligibility Group and Month in
1999 |
1: A-B |
Calendar Year (CY) 1 |
| Duration of Medicaid Enrollment (in Months) for
Persons Ever Enrolled in 1999 by Eligibility Group |
2: A-B |
CY 2: A-B |
| Medicaid Managed Care Enrollment by Plan Type and
Month in 1999 |
3: A-B |
CY 3: A-B |
| Medicaid Managed Care Enrollment by Plan Type
Combination and Month in 1999 |
4: A-C |
CY 4: A-C |
| Duration of HMO and PCCM Enrollment (in Months) for
Persons Continuously Enrolled 12 Months in Medicaid in 1999 |
5 |
CY 5 |
| Medicaid Managed Care Enrollment by Plan Type and Age
Group in December, 1999 |
6: A-B |
December 1: A-B |
| Medicaid Managed Care Enrollment by Plan Type
Combination and Age Group in December, 1999 |
7: A-B |
December 2: A-B |
| Medicaid Managed Care Enrollment by Plan Type and
Eligibility Group in December, 1999 |
8: A-B |
December 3: A-B |
| Medicaid Managed Care Enrollment by Plan Type
Combination and Eligibility Group in December, 1999 |
9: A-B |
December 4: A-B |
| Medicaid Managed Care Enrollment for Disabled Persons
and Children in Foster Care by Age Cohort, Gender and Plan Type in December,
1999 |
10: A-F |
December 5: A-F |
| Medicaid Managed Care Enrollment for Disabled Persons
and Children in Foster Care by Age Cohort, Gender and Plan Type Combination in
December, 1999 |
11: A-F |
December 6: A-F |
| Medicaid Managed Care Enrollment for Persons in Aged
and Disabled Eligibility Groups by Dual Eligible Status and Plan Type in
December, 1999 |
12: A-D |
December 7: A-D |
| Medicaid Managed Care Enrollment for Persons in Aged
and Disabled Eligibility Groups by Dual Eligible Status and Plan Type
Combination in December, 1999 |
13: A-D |
December 8: A-D |
| Medicaid Managed Care Enrollment by Plan Type and
County in December, 1999 |
Not applicable |
December 9 |
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